Individual provider Active NPI

Sandra Elizabeth Walsh, LMFT

  • Marriage & Family Therapist
  • Mankato, MN
National Provider Identifier
1578697355
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1576 Issued in MN
Practice address
201 N Broad St
Mankato, MN 56001-3585
Phone
(507) 225-1500
Fax
(507) 225-1501
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1576 MN Primary

Addresses

Primary practice location

201 N Broad St
Mankato, MN 56001-3585

Mailing address

447 Skaro St
Saint Peter, MN 56082-1989
Phone (507) 469-8380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220001436 MN Practitioner - Marriage and Family Therapist 3779933502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nystrom and Associates LTDGroup PAC ID 6406752492, 590 clinicians

Practice addresses (Care Compare)

201 N Broad St
Suite 200
Mankato, MN 56001-3569
Phone (507) 225-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1576MNMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Family Support Services Inc. CurrentSince Apr 29, 2025 Accepting new patients
Nystrom & Associates, LTD Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Leo a. Hoffmann Center, Inc. PastSince Apr 28, 2024 Accepting new patients
Leo a. Hoffmann Center, Inc. Past Accepting new patients

Locations

201 N Broad St
Ste 200
Mankato, MN 56001
Phone (507) 200-2624

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1578697355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "447 SKARO ST",
            "city": "SAINT PETER",
            "state": "MN",
            "postal_code": "560821989",
            "telephone_number": "507-469-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N BROAD ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560013585",
            "telephone_number": "507-225-1500",
            "fax_number": "507-225-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "SANDRA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

Verify at the official NPI Registry.